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General NPI Number Information
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NPI Number | 1669961033
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Entity Type | Individual
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Provider Name | PETER RASHEED ALI MD
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Gender | Male
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 11108 PARKVIEW CIRCLE DR STE 5100
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City | FORT WAYNE
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State | IN
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Zip | 46845-1730
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Country | US
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Telephone | 260-266-2800
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Fax | 260-266-2805
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Provider Business Mailing Address
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Address Line | 11109 PARKVIEW PLAZA DR # 117
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City | FORT WAYNE
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State | IN
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Zip | 46845-1701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 4301114647
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 01095925A
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License Number State | IN
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